Diabetes in Pregnancy Author: Elisha L. Brownfield, MD
Editorial changes - 2012-04-19
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Diagnosis
  • Evaluate women with pregestational diabetes for diabetic complications before conception and review issues of diabetic control, and review symptoms of hyperglycemia in all pregnant women.
  • Use laboratory testing to evaluate diabetic control and to screen for related medical conditions.
History and Physical Examination Elements for Diabetes in Pregnancy (table)
Laboratory and Other Studies for Diabetes in Pregnancy (table)

Evaluate women with pregestational diabetes for diabetic complications before conception and review issues of diabetic control, and review symptoms of hyperglycemia in all pregnant women. B

  • Screen pregnant patients with no previous history of diabetes for hyperglycemic symptoms.
  • Assess history of acute diabetic complications.
  • Review history of retinopathy, nephropathy, hypertension, atherosclerotic disease, and neuropathy.
  • Review duration and type of diabetes and current diabetes management.
  • Document other concomitant medical conditions and drugs.
  • Review basic pregnancy issues, such as past pregnancy history, menstrual history, and support system for the patient.
  • Obtain dilated retinal exam before pregnancy.
  • Measure blood pressure and test for orthostatic changes.
  • Perform cardiovascular exam to look for evidence of cardiac or peripheral vascular disease.
  • See table History and Physical Examination Elements for Diabetes in Pregnancy.
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Use laboratory testing to evaluate diabetic control and to screen for related medical conditions. B

  • Obtain the following in women with pregestational diabetes before conception:
    • HbA1c level
    • 24-hour urine test for protein and creatinine levels
    • ECG
  • Obtain blood glucose level in all pregnant women:
    • In the first trimester or at the first prenatal visit
    • With symptoms of hyperglycemia, to monitor for the development of diabetes
  • Check thyroid levels with the first set of antepartum labs in patients with type 1 diabetes.
  • See table Laboratory and Other Studies for Diabetes in Pregnancy.
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FAQs
Elisha L. Brownfield, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Justin B. Moore, MD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Deborah Korenstein, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Richard B. Lynn, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.

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